NEW REPORT SHOWS RHODE ISLAND'S PROGRESS ON PRIMARY CARE REIMBURSEMENT RATES; GOVERNOR MCKEE COMMITS TO NATIONAL-LEADING NEW INVESTMENT

The following information was released by the office of the Governor of Rhode Island:

A new September 2026 report from the Office of the Health Insurance Commissioner (OHIC) [zk8ngbyab.cc.rs6.net] highlights that Rhode Island has made significant progress strengthening Medicaid reimbursement for primary care. Following the state's increase of Medicaid primary care reimbursement rates to Medicare levels in October 2025, Rhode Island's rates now exceed Medicaid fee-for-service rates in Massachusetts, Connecticut, New Hampshire, and Maine. The report also finds Rhode Island's rates are above the national Medicaid median. ',

Building on that progress, Governor Dan McKee announced that he will propose funding the first recommendation in OHIC's report as part of his budget proposal in January, representing a national-leading new investment in primary care. The proposed investment is approximately $16.5 million including both state and federal funds, with an assumed start date of Oct. 1, 2027.

The recommendation calls for increasing Medicaid primary care reimbursement to better reflect the actual cost of delivering care, with the new rates serving as both the state's Medicaid fee-for-service rates and the reimbursement floor for Medicaid managed care organizations. In practical terms, these higher rates would give primary care practices more resources to recruit and retain providers, support their care teams, and serve Rhode Island patients.

"Rhode Island has made significant progress strengthening primary care, but there is more work to do," said Governor Dan McKee. "In my next budget, I'm committing to take the next major step and position our state to lead the country on primary care investment."

Under OHIC's independent rate model, the recommended reimbursement levels would average approximately 150% of Medicare for physician-led primary care services and 110% of Medicare for services led by advanced practice providers, compared with Rhode Island's current alignment at 100% of Medicare. Implementation of the new rates will require the state to work with the Centers for Medicare and Medicaid Services (CMS) and federal partners to secure the necessary federal approval.

The report's second recommendation would be pursued by the Administration as a multi-year strategy to strengthen primary care beyond traditional visit-based reimbursement, including developing dedicated payments to help practices build expanded care teams and support services like care management and integrated behavioral health.

Today's announcement builds on Governor McKee's April 2025 request for an expedited review of primary care reimbursement. That review was subsequently mandated by the General Assembly, with the Office of the Health Insurance Commissioner's report due and submitted on September 1, 2026. It also builds on the Administration's broader efforts to strengthen primary care, including raising Medicaid reimbursement rates and requiring commercial insurers to increase their investment in primary care.

Other Primary Care Investments

Signed the budget allocating $5 million to support development of a new medical school at the University of Rhode Island, strengthening the state's long-term physician pipeline.

Provided $6.7 million in grants to 85 primary care practices to expand access, recruit physicians and advanced practice providers, accept new patients, and increase Medicaid participation.

Required commercial health insurers to increase primary care funding through stronger reimbursement and investment requirements.

Reduced prior authorization requirements to ease administrative burdens on primary care providers.

Expanded Rhode Island's primary care student loan forgiveness program to help recruit and retain providers